Through Thick and Thin

After eons of denial, the beauty industry is finally attacking the taboo topic of female hair loss with both glamour and science.

If you have never had your hair vacuumed, I recommend it—at least when it’s performed in a glittery-chandeliered atelier and accompanied by a robust scalp massage and a series of deliciously scented oils and masks. But while this particular treatment, which the stylist Ricardo Rojas started offering last June in his salon off Manhattan’s Park Avenue, feels like a dose of glamorous pampering, it targets a highly unglamorous woe: hair loss. The tingly protein-and-ginseng-infused potions, concocted by the haute Parisian hair care line Leonor Greyl, “clean out” the follicles, as Rojas explains, and the suctioning—conducted with a bell-shaped glass cup connected to a box only slightly quieter than my Dyson—enhances circulation. When Rojas saw that the treatment, which was developed in France, could encourage new sprouts on previously barren regions of the scalp, he knew he had to bring the technology home. “So many women had been saying to me, ‘I’m losing my hair! What should I do?’ ” he says.

“They practically become suicidal over it,” says Doris Day of her patients with thinning hair.

It’s a lament hairstylists and dermatologists are hearing with increasing frequency. According to a 2012 Gallup poll, half of women 50 and older suffer from thinning hair. (Upwards of 100 strands shed a day—or more than six, consistently, with a single tug of hair—is considered statistically significant.) The causes of such thinning typically are inherited female-pattern baldness, characterized by sparsity surrounding the part, or aging. But anecdotally, complaints seem to be coming from more and younger women these days. According to Doris Day, a clinical associate professor of dermatology at New York University, “Many patients become practically suicidal over it.”

That uptick might be partially a problem of perception: Pop stars are now so bedecked in hair extensions that they’ve blurred the line between anatomical feasibility and complete fantasy, leaving even those of us with normal-size ponytails feeling inadequate. But as the New York dermatologist Julie E. Russak points out, our epic levels of stress—and consequent prescription-drug–taking—can be a factor, triggering hormone fluctuations that may irritate follicles or even cause them to go into hibernation. Whatever the case, women aren’t just obsessing over every tiny wrinkle and line anymore—they’re counting hairs. And experts, armed with decades of research borrowed from the male-pattern-baldness market, are eager to improve those numbers.

Until recently, most salon and beauty-aisle solutions had been purely cosmetic: To create the illusion of volume, tonics roughed up the hair shaft or coated it with particles. Any benefit was erased with the next shampoo. The scalp was largely ignored, even though excessive shedding is, in fact, caused by poorly functioning follicles just beneath its surface. Sure, there were Rogaine and HairMax (a laser comb that uses light energy to stimulate follicles)—both FDA-approved treatments for female hair loss. But for many women, the prospect of sharing products with their bald-spot-sporting husbands was simply too humiliating. Even the launch of an over-the-counter version of Rogaine for women, in 1996, did little to erase the stigma.

Fortunately, we’ve entered into an age of female-hair-loss-treatment enlightenment, with a slew of new offerings that are high-tech (finally crossing the hair-scalp barrier) and worlds more elegant than the Hair Club for Men. Many of the latest treatments focus on enhancing mircrocirculation—which, in turn, delivers nutrients and oxygen to shrunken, underperforming follicles. The result: more follicles in the growing phase, each producing thicker strands for a longer period of time. Rojas’s massage-and-suctioning technique approaches this mechanically. Minoxidil, the active ingredient in Rogaine, aids blood flow pharmaceutically and increases the size of the follicles. And for those who’d rather spend the rest of their lives under a wig than be caught with a box of Rogaine, the ingredient has now found its way into a new scent-free styling-product-friendly liquid by Pantene Expert, called Hair Regrowth Treatment for Women, which promises a moderate improvement in hair growth over four months.

Day, who runs a swish clinic on Manhattan’s Upper East Side, is advising her patients to swirl Rogaine into an admittedly experimental cocktail with a vial of Latisse, the hot-selling prescription lash-growing potion. Latisse’s active ingredient, bimatoprost, is currently undergoing clinical trials for FDA approval for the treatment of hair loss. “I write a prescription for them and let them know that this is an off-label use and I don’t know the stability of the two mixed together,” she says. “But I haven’t had a single patient complain of irritation or an adverse reaction.” Both ingredients are believed to lengthen the growing phase of follicles, and it’s thought that Latisse is also capable of “waking” them up in the sleeping phase, shifting them into the growing phase. Day and other doctors experimenting with Latisse are reluctant to say how well it works on the scalp until trials are complete. “I just try to be as aggressive as I can while still staying safe,” Day says.

Meanwhile, David Colbert, a Manhattan dermatologist with a Hollywood following, is focusing on another promising but early-stage area of research: growth factors, or compounds created by the body to, well, grow things. This past June, University of Pennsylvania researchers reported testing a particular growth factor secreted by immune cells that was capable of turning hairless skin cells into follicle-generating ones—in mice, at least. The results were positive but not quite conclusive in humans, and it may be years before researchers come up with a marketable product. In the meantime, Colbert is conducting platelet-rich-plasma (PRP) scalp injections, a procedure he likes to think of as “intense” acupuncture. “The fluid doesn’t hurt as it goes in—you just feel 30 to 40 pricks on your scalp,” he says.

The fluid in question is drawn from the patient’s own blood, which is centrifuged to separate out a golden tonic of growth factors. The therapy has been used for the healing of wounds for decades, and the notion of injecting the scalp came to Colbert after he received PRP three years ago to treat a torn hamstring. While study results are mixed, they’re not entirely discouraging. A 2012 International Journal of Trichology article suggested that the growth factors act as “biologic switches” that turn follicles on; a 2005 study reported that hair-transplant patients saw a 15 percent improvement in areas treated with PRP. No, not exactly amazing, but “moderate,” says Colbert, who started offering the treatment a year after his injury and is developing his own brand of follicle-stimulating topical serum, to be released in 2015. “It’s helpful,” he says of the injection therapy. “It gives a little bump in the direction toward growth.”

The same might be said of all the current options, from scalp suckers to prescription potions to the glut of new luxe skin-care-inspired products. None of them has the power to transform Yul Brynner into Beyoncé anytime soon. But if you have the hours and the energy, then all the fuss might be worth it. After all, even if some of the science is a bit, um, thin at the moment, the extra pampering might just vanquish a bit of stress—which may have been all your follicles needed in the first place.